MS CH 50 Nursing Care of Patients With Peripheral Nervous System Disorders

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Questions and Answers

What is a common consequence of immobility in patients with MS that might lead to respiratory complications?

Weakness of the diaphragm and intercostal muscles (correct)

Bowel and bladder dysfunction

Increased oligoclonal immunoglobulin G (IgG)

Increased muscle spasticity

Which of the following is a diagnostic test that can help identify sclerotic plaques in patients with MS?

Physical examination for muscle weakness

Analysis of cerebrospinal fluid

Magnetic resonance imaging (MRI) (correct)

Blood test for oligoclonal IgG

Which medication is NOT typically used to manage muscle spasms in multiple sclerosis?

Bethanechol (Urecholine) (correct)

Tizanidine (Zanaflex)

Diazepam (Valium)

Baclofen (Lioresal)

Which of the following is a newer class of MS medications that is designed to reduce relapses and new lesions?

Oral teriflunomide and dimethyl fumarate (C) Signup and view all the answers

What is a common symptom that can result in accidents and falls in patients with MS?

Muscle weakness or numbness (B) Signup and view all the answers

Which type of medication is often prescribed to manage neuropathic pain associated with MS?

Anticonvulsants (B) Signup and view all the answers

Which of the following is NOT a typical symptom of MS?

Decreased oligoclonal immunoglobulins (C) Signup and view all the answers

Which medication is used to alleviate severe fatigue in MS?

Amantadine (C) Signup and view all the answers

What is the primary goal of treatment for Myasthenia Gravis (MG)?

Managing the symptoms of the disease. (A) Signup and view all the answers

What type of activity is important to record at a patient's baseline assessment?

How much activity they can tolerate before fatigue and muscle weakness. (C) Signup and view all the answers

The improvement of which symptom is used to confirm a diagnosis of MG?

Dramatic improvement in muscle strength (B) Signup and view all the answers

What does Electromyography (EMG) help to achieve in a patient suspected of having MG?

Rule out other conditions (A) Signup and view all the answers

Which of the following best describes the purpose of scheduling anticholinesterase drugs in relation to patient activities?

To maximize muscle strength at times when necessary for activities. (C) Signup and view all the answers

What is the main purpose of performing pulmonary function tests on a patient with MG?

To predict potential myasthenic crises (C) Signup and view all the answers

What is the significance of the presence of anti-ACh receptor antibodies in a patient's blood pertaining to a diagnosis of MG?

The antibodies are present in most patients with MG. (B) Signup and view all the answers

What is the impact of thymectomy on the production of ACh receptor antibodies?

It decreases production in a majority of the patients. (A) Signup and view all the answers

What is the primary physiological effect of amyotrophic lateral sclerosis (ALS) on motor neurons?

Degeneration and scar tissue formation, blocking nerve impulses. (B) Signup and view all the answers

Which of the following muscles may be affected as ALS progresses?

Muscles controlling breathing and swallowing. (C) Signup and view all the answers

What is the purpose of augmentative alternative communication systems for patients with ALS?

To provide a way to generate speech through typing or symbols. (A) Signup and view all the answers

Why are physical, occupational, and speech therapies vital for patients with ALS?

To maximize function and control and reduce complications. (C) Signup and view all the answers

Which condition is described as having the most distal nerves demyelinating first, followed by a symmetrical ascension?

A diffuse inflammatory reaction of the nerves. (C) Signup and view all the answers

What is the primary mechanism of nerve damage in the described inflammatory reaction?

Lymphocyte infiltration and segmental demyelination. (D) Signup and view all the answers

What is the consequence of the segmental demyelination mentioned in the text?

Slowed or blocked nerve conduction. (C) Signup and view all the answers

Why is meticulous skin care important for patients with severe motor neuron diseases?

To prevent pressure ulcers. (B) Signup and view all the answers

What is a serious risk associated with difficulty chewing and swallowing in patients with neuromuscular disorders?

Choking and aspiration (A) Signup and view all the answers

Which of the following is a typical motor symptom of progressive neuromuscular disorders?

Progressive muscle weakness (D) Signup and view all the answers

What are fasciculations, in the context of a neuromuscular disorder?

Muscle twitching (D) Signup and view all the answers

What is a common non-motor symptom that can occur in patients with progressive neuromuscular disorders?

Inappropriate emotional outbursts (C) Signup and view all the answers

What method may be the only means of communication for patients in the late stages of neuromuscular disorders?

Moving and blinking the eyes (A) Signup and view all the answers

Which of the following is a potential complication, related to poor nutrition in advanced neuromuscular disease?

Extreme malnutrition (B) Signup and view all the answers

What is a crucial step when a patient with Myasthenia Gravis is taking medications from multiple providers?

Check all medications with the MG treating provider (D) Signup and view all the answers

According to the content provided, what is a resource for support for patients and their families dealing with neuromuscular disorders?

Support groups and organizations such as the Myasthenia Gravis Foundation of America (B) Signup and view all the answers

Why might a patient with a respiratory issue deny having difficulty breathing?

They fear they will require intubation and mechanical ventilation. (B) Signup and view all the answers

Which of the following is a reason why mobility should be encouraged with these types of patients?

To prevent muscle atrophy, deep venous thrombosis, and skin breakdown. (A) Signup and view all the answers

What is a typical finding in cerebrospinal fluid (CSF) analysis of a patient with this condition?

Normal cell count with an elevated protein level. (A) Signup and view all the answers

Which diagnostic test is used to evaluate nerve function?

Electromyographic and nerve conduction velocity tests (D) Signup and view all the answers

What is the primary purpose of using diversional activities during treatment?

To alleviate boredom, loneliness, and depression. (C) Signup and view all the answers

Why is encouraging family participation in patient care beneficial?

It helps the patient and family gain a sense of control over the situation and prepare for discharge (B) Signup and view all the answers

What does pulmonary function testing help confirm in relation to this disease?

Impending respiratory problems. (B) Signup and view all the answers

What is a key element of the evaluation during this patient's treatment?

The patient and family's demonstrated understanding of the disease process. (B) Signup and view all the answers

What is a characteristic symptom during the ascending phase of a disease as outlined in the provided content?

Muscle spasms (D) Signup and view all the answers

Which diagnostic test is used to help diagnose myasthenia gravis?

Ptosis test (D) Signup and view all the answers

What is a common therapeutic measure used for a disease during the plateau phase, as indicated in the provided content?

Anticholinesterase agents (A) Signup and view all the answers

Which of the following is a priority nursing diagnosis related to many of these conditions?

Ineffective airway clearance (A) Signup and view all the answers

A patient is experiencing muscle twitching. According to the content, during which phase is this symptom most likely to occur?

Plateau (B) Signup and view all the answers

What therapeutic measure might be used during the descending phase of a disease, according to the content?

Antispasmodics/quinine (C) Signup and view all the answers

What is a complication that is especially mentioned during the descending phase?

Depression (D) Signup and view all the answers

Which diagnostic procedure is listed for both ascending and descending phases of a disease?

CSF Analysis (A) Signup and view all the answers

Which of these is a nursing diagnosis that is listed as a priority?

Impaired physical mobility (C) Signup and view all the answers

In which phase of a disease does the content mention the use of alternative communication devices?

Descending (B) Signup and view all the answers

What is the primary focus of new research regarding treatments for multiple sclerosis (MS)?

Regenerating myelin (D) Signup and view all the answers

Which of the following is a potential therapeutic measure used for MS when high doses of steroids are not effective?

Plasmapheresis (B) Signup and view all the answers

Which of the following best describes the primary action of myelin in the nervous system?

Ensuring smooth transmission of nerve impulses. (D) Signup and view all the answers

In multiple sclerosis (MS), what is the primary process that affects the myelin sheath?

Degeneration and breakdown. (B) Signup and view all the answers

What does evoked potential testing help to determine for individuals with MS?

The speed of nerve impulse transmission (D) Signup and view all the answers

Which type of therapy is crucial for helping patients with MS adapt their living spaces?

Occupational therapy (B) Signup and view all the answers

Which of the following is NOT identified as a potential trigger for MS symptom onset or exacerbation?

Physical exertion with proper rest. (D) Signup and view all the answers

What is the primary intended effect of steroid medications like prednisone in treating MS?

To decrease inflammation and edema of neurons. (D) Signup and view all the answers

Besides mobility aids, what other type of assistive device is mentioned to help MS patients?

Splints (D) Signup and view all the answers

Which of the following symptoms is specifically highlighted as a common visual disturbance associated with MS?

Visual disturbances in one eye at a time. (B) Signup and view all the answers

Which of these visual disturbances is associated with multiple sclerosis (MS)?

Scotomas (C) Signup and view all the answers

What therapeutic measure is often used to address speech difficulties in MS patients?

Speech therapy (D) Signup and view all the answers

What is the main goal of using interferon therapy with medications such as Betaseron or Avonex?

To reduce symptom exacerbations and delay disability progression. (A) Signup and view all the answers

According to the content, what is a characteristic of the onset of MS symptoms, regarding speed?

Symptoms may begin gradually or abruptly. (D) Signup and view all the answers

What is a major goal of physical rehabilitation for patients after an acute MS episode?

To help adapt to the home environment (C) Signup and view all the answers

What is the functional consequence of the degradation of the myelin sheath in patients with MS?

Interrupted transmission of nerve impulses. (A) Signup and view all the answers

According to the provided text, what is a primary goal of plasmapheresis in the treatment of certain neuromuscular disorders?

To lessen the body's immune response. (C) Signup and view all the answers

According to the content, what is the typical timeframe recommended for initiating plasmapheresis after the onset of symptoms to maximize its effectiveness?

Within 7 to 14 days. (D) Signup and view all the answers

What type of intervention, as mentioned in the provided content, is recommended to prevent complications such as deep vein thrombosis?

Anticoagulant therapy. (D) Signup and view all the answers

According to the content, what is a key focus of rehabilitation during the recovery phase of certain conditions related to peripheral nervous system disorders?

Regaining functional abilities. (A) Signup and view all the answers

Based on the content provided, what percentage of patients previously affected by polio might develop postpolio syndrome?

Up to 40%. (B) Signup and view all the answers

What is the primary factor that determines the severity of postpolio syndrome according to the information provided?

The extent of residual weakness and disability from the initial illness. (A) Signup and view all the answers

According to the information provided, what is a common symptom related to postpolio syndrome?

Further weakening of muscles affected by previous polio. (C) Signup and view all the answers

Considering the information on postpolio syndrome, how long after a person has recovered from polio does this syndrome typically manifest?

Between 20 and 40 years post recovery. (D) Signup and view all the answers

What is the typical age range of onset for Guillain-Barré Syndrome (GBS)?

30 to 50 years (C) Signup and view all the answers

During the plateau phase of GBS, which of the following is a common patient experience?

Discouragement due to lack of improvement (B) Signup and view all the answers

Which of the following best describes the initial presentation of muscle weakness in Guillain-Barré syndrome?

Symmetrical weakness that progresses to paralysis (D) Signup and view all the answers

Which of the following is a potential autonomic nervous system effect, often experienced by patients with GBS?

Labile blood pressure, cardiac dysrhythmias and urine retention (D) Signup and view all the answers

What is the duration of the plateau stage in Guillain-Barré syndrome?

2 to 14 days (D) Signup and view all the answers

According to the text provided, which of these options is a characteristic symptom of GBS?

Abrupt onset of symmetrical paresis (weakness) (D) Signup and view all the answers

How does the patient's inability to move voluntarily impact their discomfort associated with GBS?

It intensifies pain, cramping, and other discomfort (C) Signup and view all the answers

Which of the following best defines the term 'demyelination' as described in the context?

The process of destroying or removing the myelin sheath surrounding neurons (A) Signup and view all the answers

Which anticonvulsant is NOT typically used in the management of trigeminal neuralgia?

Sodium valproate (D) Signup and view all the answers

What surgical procedure is indicated if no vessel is found to be compressing the trigeminal nerve?

Neurectomy (A) Signup and view all the answers

What is a potential side effect of surgical options for treating trigeminal neuralgia?

Varying degrees of numbness (A) Signup and view all the answers

Which branch of the trigeminal nerve is NOT involved in its sensory function?

Accessory branch (B) Signup and view all the answers

Which medication is suggested as potentially effective for controlling symptoms of trigeminal neuralgia?

Clonazepam (C) Signup and view all the answers

Which of the following symptom descriptions best characterizes trigeminal neuralgia pain?

Sudden and jabbing (C) Signup and view all the answers

What non-pharmacological therapy is mentioned as having varying success in the management of trigeminal neuralgia?

Acupuncture (A) Signup and view all the answers

At what age does trigeminal neuralgia most commonly begin?

50-60 years (C) Signup and view all the answers

Which symptom is commonly associated with the plateau phase of a neuromuscular disorder?

Muscle twitching (C) Signup and view all the answers

What is one of the therapeutic measures recommended during the descending phase of a neuromuscular disorder?

Thymectomy (A) Signup and view all the answers

Which diagnostic test is specifically used to evaluate muscle function in suspected myasthenia gravis?

EMG (C) Signup and view all the answers

What complication is associated with aspiration in patients with neuromuscular disorders?

Respiratory infections (C) Signup and view all the answers

Which priority nursing diagnosis addresses the nutritional needs of patients with neuromuscular disorders?

Risk for Imbalanced Nutrition: Less Than Body Requirements (A) Signup and view all the answers

During which phase is there a risk for a myasthenic crisis or cholinergic crisis as a complication?

Descending (D) Signup and view all the answers

What type of activity is included as part of therapeutic measures to support patient care?

Physical therapy (B) Signup and view all the answers

Which symptom is indicative of emotional changes that can arise in neuromuscular disorders?

Emotional outbursts (D) Signup and view all the answers

Which therapeutic measure is best suited for alleviating muscle spasms in patients with neuromuscular disorders?

Antispasmodics (A) Signup and view all the answers

What is an important aspect of the CSF analysis in the context of diagnosing neuromuscular disorders?

Presence of oligoclonal bands (B) Signup and view all the answers

What is the primary rationale for frequently evaluating cough, swallow, and gag reflexes in a patient at risk for imbalanced nutrition due to muscle weakness?

To determine the need for a feeding tube based on the patient's swallowing ability. (C) Signup and view all the answers

Which type of foods should be offered to a patient with impaired chewing and swallowing abilities according to the provided interventions?

Soft foods that require less effort to chew and swallow. (C) Signup and view all the answers

What is the primary role of a speech therapist when consulted for a patient with difficulty swallowing, as indicated in the text?

To evaluate the patient's swallowing function and make recommendations. (B) Signup and view all the answers

How do swallowing precautions assist patients who have issues with muscle weakness?

They guide patients in the safest ways to consume oral intake, thereby reducing the risk of aspiration. (A) Signup and view all the answers

What is the main objective of assessing a patient's ability to speak and communicate when addressing impaired verbal communication?

To determine the most appropriate interventions to support the patient's communication needs. (D) Signup and view all the answers

How does a speech therapist contribute to improving communication for a patient with impaired muscle function, according to the text?

They make recommendations for alternative communication techniques. (C) Signup and view all the answers

What is the significance of monitoring nonverbal pain and distress signs, like restlessness and grimacing, in patients with impaired communication skills?

These behaviors are a sign of discomfort and a way that the patient is expressing their pain when they cannot verbally communicate. (C) Signup and view all the answers

According to the intervention guidelines, what is the initial step before determining appropriate communication interventions for a patient with impaired speech?

Assess patient's capability to use spoken communication and identify their specific communication needs. (D) Signup and view all the answers

What is a key reason patients may deny respiratory difficulties?

Fear of emergency interventions (B) Signup and view all the answers

Which of the following diagnostic tests is primarily used to assess nerve function?

Electromyographic testing (C) Signup and view all the answers

What is the potential benefit of diversional activities for patients during recovery?

Alleviates boredom and anxiety (D) Signup and view all the answers

What role does family involvement play in a patient's recovery process?

It provides a sense of control in care decisions (D) Signup and view all the answers

How does immobility impact patients in the context of the disease described?

It may lead to skin breakdown and thrombosis (B) Signup and view all the answers

What aspect of care is crucial during the initial stages of a patient's illness?

Providing calm and supportive reassurance (A) Signup and view all the answers

What is indicated when a lumbar puncture shows an elevated protein level with a normal cell count?

Potential neurological disorder (B) Signup and view all the answers

What is the main goal of pulmonary function testing in patients with respiratory issues?

To assess and identify impending respiratory problems (B) Signup and view all the answers

Which of the following best describes the nature of pain experienced in trigeminal neuralgia?

Pain can occur in clusters, lasting a few seconds to minutes. (D) Signup and view all the answers

What triggers can lead to attacks of pain in trigeminal neuralgia?

Talking and chewing. (D) Signup and view all the answers

What might be a necessary intervention during sleep for a patient with trigeminal neuralgia?

Wearing an eye patch. (A) Signup and view all the answers

In the context of Bell's palsy, which nerve becomes inflamed and edematous?

Cranial nerve VII. (B) Signup and view all the answers

What is a potential consequence if recovery from Bell's palsy is delayed?

Contracture of facial muscles. (A) Signup and view all the answers

Which viral infections are thought to contribute to the nerve trauma seen in Bell's palsy?

Epstein-Barr and herpes simplex. (B) Signup and view all the answers

What symptom is characteristically observed on the affected side of the face in trigeminal neuralgia?

Frequent blinking and tearing. (C) Signup and view all the answers

What general behavior might patients with trigeminal neuralgia exhibit to avoid pain?

Avoiding activities like talking and eating. (A) Signup and view all the answers

What complication can arise from muscle weakness associated with Myasthenia Gravis?

Difficulty with chewing and swallowing (D) Signup and view all the answers

Which statement best describes a common emotional symptom in patients with Myasthenia Gravis?

Frequent emotional outbursts of laughter and crying (A) Signup and view all the answers

What is a potential consequence of advanced Myasthenia Gravis related to respiratory function?

Compromised pulmonary function requiring mechanical support (D) Signup and view all the answers

Which of the following issues is NOT typically intact in patients with Myasthenia Gravis?

Muscle coordination (A) Signup and view all the answers

What symptom progression may indicate late-stage Myasthenia Gravis?

Complete inability to communicate verbally (B) Signup and view all the answers

In what context is it important to monitor medication use in patients with Myasthenia Gravis?

To prevent medication interference and muscle exacerbation (A) Signup and view all the answers

What is a potential serious nutritional complication for patients with advanced Myasthenia Gravis?

Extreme malnutrition (B) Signup and view all the answers

Which of the following is a risk associated with swallowing difficulties in patients with Myasthenia Gravis?

Higher likelihood of choking (C) Signup and view all the answers

What is the classic sign of Myasthenia Gravis that differentiates it from other neuromuscular disorders?

Increased muscle weakness with activity (D) Signup and view all the answers

Which of the following is NOT an appropriate intervention for a patient with communication difficulties related to neuromuscular disorders?

Encouraging spontaneous verbal communication (B) Signup and view all the answers

What factor is associated with a higher incidence of Myasthenia Gravis in women?

Age of onset between 20 to 30 years (C) Signup and view all the answers

How does Myasthenia Gravis primarily affect the neuromuscular junction?

By blocking acetylcholine receptors (A) Signup and view all the answers

Which evaluation method is critical in determining the effectiveness of interventions for a patient with communication difficulties?

Patient indication of understanding (C) Signup and view all the answers

What role does the thymus gland play in the context of Myasthenia Gravis?

Involvement in autoimmune response (A) Signup and view all the answers

What is a primary factor contributing to the heightened muscle weakness observed in patients with Myasthenia Gravis during physical activity?

Increased antibody activity at neuromuscular junction (A) Signup and view all the answers

In which population is Myasthenia Gravis more frequently observed due to age-related factors?

Elderly males over 60 years (B) Signup and view all the answers

What is the primary reason why the heart and GI tract are not affected by Amyotrophic Lateral Sclerosis (ALS)?

ALS primarily affects the muscles responsible for voluntary movements, while the heart and GI tract operate involuntarily. (D) Signup and view all the answers

What is the primary physiological effect of the inflammatory reaction in Multiple Sclerosis (MS) on the nervous system?

The inflammatory reaction causes a direct destruction of the myelin sheath surrounding nerve fibers. (B) Signup and view all the answers

In the context of ALS, what is the pathological reason why muscle strength and coordination decline over time?

The progressive degeneration of motor neurons leads to a decrease in nerve impulses, causing muscle atrophy and weakness. (A) Signup and view all the answers

What is the primary mechanism by which segmental demyelination in MS causes slowed or blocked nerve conduction?

Segmental demyelination disrupts the insulation of nerve fibers, leading to the leakage of electrical signals and impaired conduction. (C) Signup and view all the answers

Which of the following statements correctly describes the progression of demyelination in MS?

Demyelination starts in the most distal nerves and ascends in a symmetrical fashion. (C) Signup and view all the answers

Based on the information provided, why is meticulous skin care essential for patients with severe motor neuron diseases?

Because impaired mobility increases the risk of pressure ulcers due to prolonged pressure on the skin. (D) Signup and view all the answers

What is the primary purpose of augmentative alternative communication systems for patients with ALS?

To provide a means of communication when speech is impaired or lost. (A) Signup and view all the answers

What is one potential benefit of early treatment for multiple sclerosis?

Delay of the disease's progression (B) Signup and view all the answers

Which therapeutic measure is used to assist patients with mobility and independence in multiple sclerosis?

Use of assistive devices (B) Signup and view all the answers

Which symptom is associated with multiple sclerosis that affects the vision?

Patchy blindness (B) Signup and view all the answers

What rehabilitation therapy specifically aids in addressing speech difficulties in multiple sclerosis patients?

Speech therapy (D) Signup and view all the answers

What role do therapeutic measures play after an acute episode of multiple sclerosis?

They assist in adapting the environment to patient needs (C) Signup and view all the answers

What emerging focus is being researched in the field of multiple sclerosis treatment?

Myelin regeneration therapies (B) Signup and view all the answers

Which factors do physical activity and self-efficacy impact in persons with multiple sclerosis?

Quality of life (C) Signup and view all the answers

What common condition could present similarly to symptoms of multiple sclerosis, complicating diagnosis?

Peripheral neuropathy (B) Signup and view all the answers

Which of the following pain relief methods helps to enhance a patient's control over pain?

Using a patch over the affected eye (A) Signup and view all the answers

What precaution should a patient take to protect their eyes, especially in environments with airborne particles?

Use glasses or goggles (A) Signup and view all the answers

What alternative communication method can be utilized for a patient who may struggle to speak clearly due to pain?

Providing a paper and pencil for writing (D) Signup and view all the answers

Which method is NOT mentioned as an alternative pain relief measure?

Physical therapy exercises (C) Signup and view all the answers

During what timeframe should hygiene activities be planned to minimize discomfort?

When pain intensity is at its peak (B) Signup and view all the answers

What could be a potential reason for patients to deny respiratory difficulty?

Concerns about necessary intubation (D) Signup and view all the answers

Which of the following consequences is most directly linked to immobility in patients?

Development of deep venous thrombosis (B) Signup and view all the answers

During recovery, what is a vital reason for involving family members in patient care?

To increase the patient's sense of control (B) Signup and view all the answers

What finding is typical in the analysis of cerebrospinal fluid for patients with certain neurologic conditions?

Normal cell count with an elevated protein level (D) Signup and view all the answers

What role does the use of diversional activities serve in the treatment of patients with respiratory or neurological difficulties?

To help alleviate boredom and depression (B) Signup and view all the answers

What physiological change is most concerning if pulmonary function testing indicates impending respiratory problems?

Decreased lung flexibility (B) Signup and view all the answers

During the initial stages of recovery for patients with respiratory issues, which treatment might they require?

Mechanical ventilation support (D) Signup and view all the answers

Why is calm and supportive reassurance essential for patients during the recovery process?

It helps alleviate fear and anxiety (A) Signup and view all the answers

What is the most significant method that aided recovery following Bell's palsy?

Time (C) Signup and view all the answers

Which symptom of Bell's palsy was reported to overshadow labor pains during childbirth?

Severe headache (D) Signup and view all the answers

Which of the following interventions was NOT mentioned as a method attempted for recovery from Bell's palsy?

Speech therapy (C) Signup and view all the answers

During the first 15 weeks after being diagnosed with Bell's palsy, what emotional state did the individual experience?

Desire to withdraw from social interactions (B) Signup and view all the answers

Which side effect was recommended to avoid in patients recovering from Bell's palsy?

Chewing on the affected side (D) Signup and view all the answers

What aspect of recovery does the individual mention as having regained significantly after 7 months?

Muscle control (A) Signup and view all the answers

What was a continuous request made by the individual during labor related to their Bell's palsy condition?

Eyedrops for eye comfort (B) Signup and view all the answers

What kind of therapy was mentioned as an attempt to manage Bell's palsy symptoms?

Shock treatments (C) Signup and view all the answers

Which symptom is NOT commonly associated with multiple sclerosis (MS)?

Breathing difficulties (A) Signup and view all the answers

Which factor is most likely to worsen multiple sclerosis symptoms?

Ignoring symptom triggers (C) Signup and view all the answers

What is the primary benefit of plasmapheresis in the context of neuromuscular disorders?

It removes harmful antibodies from the plasma. (A) Signup and view all the answers

Which of the following is considered a significant self-care step for managing symptoms of multiple sclerosis?

Rest and moderate exercise (A) Signup and view all the answers

What psychological symptoms are commonly reported by individuals with multiple sclerosis?

Euphoria and anger (B) Signup and view all the answers

Which nursing intervention is essential for supporting a patient with multiple sclerosis?

Instructing on stress management strategies (D) Signup and view all the answers

Which symptom is associated with both a spastic bladder and a flaccid bladder in terms of its impact on patients?

Sexual dysfunction (C) Signup and view all the answers

Which approach should nursing staff encourage to improve the quality of life for patients with MS?

Engage patients in their treatment plans (B) Signup and view all the answers

What is the primary purpose of providing a facial sling to a patient with Bell's palsy?

To aid in oral care and eating (B) Signup and view all the answers

Which of the following interventions is NOT commonly recommended for managing pain in trigeminal neuralgia?

Soft bristle toothbrushes (B) Signup and view all the answers

Which diagnostic approach is primarily used to confirm the diagnosis of Bell's palsy?

Observation of symptoms and history (D) Signup and view all the answers

What lifestyle modification is essential for a patient diagnosed with trigeminal neuralgia?

Avoiding cold or windy environments (D) Signup and view all the answers

What is the intended outcome of providing prednisone to a patient with Bell's palsy?

To decrease inflammation (D) Signup and view all the answers

Which of the following is a potential complication due to the dietary restrictions in patients with oral pain management needs?

Nutritional deficiencies (C) Signup and view all the answers

Which therapeutic measure can help alleviate pain in a patient suffering from Bell's palsy?

Warm, moist compresses (B) Signup and view all the answers

What is the primary goal of treatment for a patient with Bell's palsy?

To prevent facial muscular atrophy (B) Signup and view all the answers

Study Notes

Nursing Care of Patients With Peripheral Nervous System Disorders

Learning Outcomes:
- Identify disorders caused by peripheral nervous system disruption
- Explain pathophysiology, signs, symptoms, and complications of selected PNS disorders
- Identify therapeutic measures for selected PNS disorders
- List common nursing diagnoses for PNS disorders
- Plan prioritized nursing interventions for patients with PNS disorders
- Evaluate the effectiveness of nursing care

Neuromuscular Disorders

Chronic and degenerative neurologic conditions
Disrupt impulse transmission between neurons and muscles
Result in muscle weakness
Respiratory system involvement can cause deadly complications like pneumonia and respiratory failure
Common disorders include multiple sclerosis, myasthenia gravis, amyotrophic lateral sclerosis, and Guillain-Barré syndrome

Multiple Sclerosis (MS)

Chronic progressive degenerative disease affecting the myelin sheath of CNS neurons
Myelin disruption interferes with nerve impulse transmission
Causes inflammation and scarring (sclerosis) of the nerves
Symptoms vary, depending on which nerves are affected, ranging from mild illness to permanent disability or death
Common symptoms: muscle weakness, tingling sensations, numbness, visual disturbances, double vision, and potential problems with bowel/bladder.
Treatment focused on managing symptoms and delaying progression (e.g., interferon therapy, steroids, immunosuppressants, plasmapheresis).
Disease course is unpredictable, with variations in symptom presentation

Myasthenia Gravis (MG)

Chronic autoimmune disease of the neuromuscular junction
Immune system attacks and destroys acetylcholine receptors
Decreased acetylcholine receptors hinder muscle contraction
Symptoms include progressive muscle weakness, especially with activity, and improving muscle strength after rest
Typical symptoms include drooping eyelids (ptosis), facial weakness, swallowing difficulties, and breathing problems
Can experience periods of exacerbation and remission
May experience difficulty chewing, swallowing, and speaking; sometimes also difficulty with respiratory function
Treatment includes anticholinesterase drugs (e.g., neostigmine, pyridostigmine), steroids, thymectomy, and plasmapheresis.

Amyotrophic Lateral Sclerosis (ALS)

Progressive, degenerative disease affecting motor neurons
Motor neurons responsible for voluntary muscle control degenerate and form scar tissue, blocking nerve impulses
Muscles atrophy and strength and coordination decline
Disease gradually impacts muscle groups controlling breathing and swallowing
The disease eventually leads to respiratory failure and death
Riluzole (Rilutek) can slow progression, but no cure
Treatment is palliative, aimed at managing symptoms and improving quality of life

Guillain-Barré Syndrome (GBS)

Rare inflammatory disorder of peripheral nerves
Caused by an autoimmune response to viral infection
Characterized by ascending paralysis that begins in the legs and ascends the body
Common features: progressive weakness, numbness, and respiratory compromise
May require mechanical ventilation, depending on severity
Recovery can take months to years
Treatment includes plasmapheresis or intravenous immunoglobulin therapy

Cranial Nerve Disorders

Trigeminal neuralgia (TN): recurring episodes of intense pain, often triggered by stimulation (e.g., chewing)
Bell's palsy: acute paralysis of the facial nerve (VII), typically caused by inflammation
Associated with loss of facial movement on one side; temporary, often resolving without treatment
Can involve sensory or motor functions of the fifth cranial nerve; often presenting with a sudden onset of intense facial pain and/or noticeable muscular weakness and drooping on one side of the face

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Description

Test your knowledge on the management and symptoms of Multiple Sclerosis (MS) and Myasthenia Gravis (MG). This quiz covers diagnostic tests, medications, and typical patient experiences related to these conditions. Ideal for medical students and healthcare professionals.